Medical Treatment in Shanghai for Foreigners: A Swedish Patient Case
A 68-year-old visiting scholar from Sweden developed severe gastrointestinal bleeding while staying in Shanghai. With a complex medical history including atrial fibrillation, heart failure and a previous liver transplant, her treatment required coordination across multiple medical specialties at Zhongshan Hospital, Fudan University.
A Medical Emergency During an Academic Visit to China
A 68-year-old professor, referred to as Justin (pseudonym) in the original hospital report, travelled from Helsinki to Shanghai for a short-term academic visit and research exchange.
About one week before travelling to China, she had already begun experiencing gastrointestinal symptoms, including frequent diarrhea, nausea, vomiting and reduced appetite.
Initially believing that she was experiencing a relatively ordinary gastrointestinal illness, she proceeded with her trip.
After arriving in Shanghai, however, her condition deteriorated dramatically.
She developed severe gastrointestinal bleeding, with the hospital reporting episodes of bloody stool occurring more than 20 times per day.
Continued blood loss created a potentially serious risk of complications, including hemorrhagic shock.
The situation was particularly challenging because she had travelled to China alone. Her family remained in Europe, and she was facing a serious medical emergency in an unfamiliar country.
Faculty and students from the university she was visiting accompanied her to the International Medical Department of Zhongshan Hospital, Fudan University.
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A Complex Medical History Made Treatment More Difficult
The gastrointestinal bleeding was only one part of the medical challenge.
After admission, the medical team reviewed her history and found several significant pre-existing conditions.
She had a history of:
Persistent atrial fibrillation
Heart failure
Long-term anticoagulant therapy
Liver transplantation in 2024
Previous acute kidney injury following transplantation
These conditions created competing medical priorities.
For example, anticoagulant medication can be important for reducing the risk of blood clots in patients with atrial fibrillation.
However, anticoagulation can also complicate the management of active bleeding.
At the same time, her previous liver transplantation meant that her immunosuppressive medication and transplanted organ function also needed careful monitoring.
The medical team therefore needed to manage not only the immediate gastrointestinal emergency, but also potential risks involving her cardiovascular, renal and liver function.
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Colonoscopy Performed on the Day of Admission
According to Zhongshan Hospital’s report, the International Medical Department coordinated a colonoscopy on the day she was admitted.
The examination led to a diagnosis of ischemic colitis.
Ischemic colitis occurs when blood flow to part of the large intestine is temporarily reduced, potentially causing inflammation and injury to the intestinal tissue.
Following diagnosis, targeted treatment was initiated and the gastrointestinal bleeding was brought under control.
Her condition initially appeared to stabilize.
However, approximately one week after admission, new complications developed.
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New Complications During Hospitalization
The patient’s abdomen gradually became distended, and she stopped passing stool and gas.
Further evaluation indicated a partial intestinal obstruction.
At the same time, inflammatory markers and blood creatinine levels increased significantly, raising concerns about worsening infection and acute kidney injury.
The situation therefore evolved from a gastrointestinal bleeding emergency into a more complicated medical problem involving several organ systems.
Multiple specialist teams became involved in her treatment.
General surgeons evaluated the intestinal obstruction and determined that emergency surgery was not required at that stage.
Conservative management, including temporary fasting and gastrointestinal decompression, was used.
Infectious disease specialists assisted with antimicrobial management, while nephrology specialists contributed to the management and protection of kidney function.
Because her condition remained serious, she was subsequently transferred to a high-dependency unit for closer monitoring.
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Multidisciplinary Treatment for a High-Risk International Patient
Managing the patient’s condition required several medical priorities to be addressed simultaneously.
According to the hospital, treatment included measures aimed at:
Maintaining circulation and organ perfusion
Fluid management was used to support circulation while the medical team monitored the effects on her cardiovascular and other organ functions.
Controlling intestinal inflammation
Treatment was adjusted according to the progression of her intestinal condition.
Balancing bleeding and thrombosis risks
Because of her history of atrial fibrillation and long-term anticoagulant use, doctors needed to carefully balance the risk of further bleeding against the risk of thrombosis.
Protecting kidney, liver and heart function
Her existing medical history meant that these organ systems required continued monitoring throughout treatment.
Managing post-transplant medication
The liver transplant follow-up team monitored medication levels and adjusted her anti-rejection medication when necessary.
Rather than relying on one specialty, her treatment involved coordination between multiple departments.
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Gradual Recovery and Discharge
Over time, the patient’s condition began to improve.
According to the hospital’s account:
Gastrointestinal bleeding stopped
Bowel function gradually returned
Abdominal distension improved significantly
The gastric tube was removed
Normal eating was gradually resumed
Infection-related indicators improved
Organ function stabilized
Antibiotic treatment was progressively reduced
By early the following month, the hospital reported that her clinical indicators had returned to normal and she was discharged.
She subsequently expressed her appreciation for both the medical treatment and the support she received while hospitalized in Shanghai.
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English-Speaking Care During Hospitalization
One aspect of this case that may be particularly relevant to international patients was communication.
The patient communicated exclusively in English during her hospitalization.
According to Zhongshan Hospital, members of the medical and nursing teams were able to communicate with her in English and explain her condition, treatment plans and important care instructions.
For someone hospitalized alone in another country, communication can become an important part of the overall healthcare experience.
However, the availability and level of English-language support can vary considerably between hospitals, departments and individual medical professionals in China.
International patients should therefore confirm language arrangements with the relevant hospital in advance whenever possible.
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What Can International Patients Learn From This Case?
1. Major Chinese hospitals can manage highly complex international patient cases
This was not a simple case of gastroenteritis or routine gastrointestinal bleeding.
The patient had several pre-existing medical conditions, had previously undergone a liver transplant, required anticoagulation and subsequently developed additional complications during hospitalization.
Her treatment therefore required input from several medical specialties.
For international patients with complex medical histories, the capabilities of the specific hospital and medical team may matter considerably.
2. Bring your medical records when travelling
This case also illustrates why international travellers with significant medical histories should have access to important medical information.
For someone with a history of organ transplantation, cardiovascular disease or long-term medication use, information such as:
Previous diagnoses
Current medications and dosages
Surgical history
Drug allergies
Recent laboratory results
Relevant imaging or medical reports
Contact details for the treating physician at home
can be particularly useful if an unexpected medical problem occurs abroad.
Digital copies stored securely and accessible while travelling can be helpful.
3. Hospital navigation becomes much harder during an emergency
When someone is healthy, arranging registration, finding departments and communicating with hospital staff may seem manageable.
During a serious illness, particularly when travelling alone, those tasks can become significantly more difficult.
This is one reason some international patients choose to have a local contact or medical concierge who can assist with the practical and communication aspects of receiving healthcare in China.
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Medical Care for International Patients in Shanghai
Shanghai is home to several major tertiary hospitals with extensive specialist and multidisciplinary capabilities.
Some hospitals also operate dedicated international medical departments serving overseas patients and internationally insured patients.
However, the appropriate hospital depends heavily on the patient’s condition.
A hospital with a strong reputation overall is not automatically the most appropriate institution for every disease or procedure.
For planned treatment, international patients may benefit from identifying the appropriate hospital and specialist before arriving in China.
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Important Medical Information
This article describes the experience of one individual patient. Her treatment and outcome should not be interpreted as evidence that the same approach or result would apply to another patient with gastrointestinal bleeding, ischemic colitis or similar medical conditions.
Treatment decisions must be made by qualified medical professionals following individual assessment.
For a medical emergency, patients should seek immediate medical attention rather than relying on a medical concierge or online service.
This article is independently summarized and adapted from a patient story published by Zhongshan Hospital, Fudan University. China MedCare was not involved in the patient’s diagnosis, treatment or care.
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